‘ObamaCare’ is working: more good news

“ObamaCare” is working in states where GOP governors and/or legislatures did not sabotage the Affordable Care Act by failing to establish a state-run insurance exchange and/or failed to enact expanded Medicaid coverage for its citizens , i.e., the Red State “coverage gap.” Credit: McClatchy

The uninsured rate among adults aged 18 and older in the states that have chosen to expand Medicaid and set up their own exchanges in the health insurance marketplace has declined significantly more this year than in the remaining states that have not done so. The uninsured rate, on average, declined 2.5 percentage points in the 21 states (plus the District of Columbia) that have implemented both of these measures, compared with a 0.8-point drop across the 29 states that have taken only one or neither of these actions.

As Gallup previously reported, the states that have chosen to expand Medicaid and set up their own healthcare exchanges had a lower average uninsured rate to begin with: 16.1% compared with 18.7% for the remaining states — a difference of 2.6 points. The already notable gap between the two groups of states widened in the first quarter to 4.3 points.

Nationally, 17.3% of U.S. adults reported being without health insurance in 2013, a rate that had slowly increased from 14.8% in 2008. The uninsured rate peaked at 18.0% in the third quarter of 2013 — the three months immediately preceding the opening of the healthcare exchanges — and has since declined to 15.6%.

These data, collected as part of the Gallup-Healthways Well-Being Index, are based on Americans’ self-reported insurance status in response to the question, “Do you have health insurance coverage?”

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While a majority of Americans continue to disapprove of the Affordable Care Act, also known as “Obamacare,” the uninsured rate appears to be declining, as the law intended. In turn, the states (including the District of Columbia) that have implemented two of the law’s core mechanisms — Medicaid expansion and state health insurance exchanges — are realizing a rate of decline that is substantively greater than what is found among the remaining states that have not done so. Consequently, the gap that previously existed between the two groups has now expanded.

President Obama’s health law has led to an even greater increase in health coverage than previously estimated, according to new Gallup survey data, which suggest that about 12 million previously uninsured Americans have gained coverage since last fall.

That is millions more than Gallup found in March and suggests that as many as 4 million people signed up for some kind of insurance in the last several weeks as the first enrollment period for the Affordable Care Act drew to a close.

Just 12.9% of adults nationally lacked coverage in the first half of April, initial data from the Gallup-Healthways Well-Being Index indicates, the lowest rate since the survey began in 2008.

Eighteen percent were uninsured in the third quarter of 2013, just before Americans could start shopping for coverage on the new online marketplaces created by the law.

Gallup pollsters cautioned that the data are preliminary, but said it is increasingly clear the health law is responsonible for the gains. “It is fair to say it is having a significant impact,” said Dan Witters, the survey’s research director.

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Gallup’s latest data, which parallel recent findings from Rand Corp. and the Urban Institute, lump together all coverage gains, including those on the marketplaces as well as through other forms of insurance, such as Medicaid, employer-provided coverage and health plans purchased directly from insurers.

The data also take into account any losses in coverage the law may have brought about by the cancellation of health plans that did not meet new standards.

President Obama announced on Thursday that 8 million people have signed up for plans through Obamacare’s new insurance exchanges. Although March 31 was originally the final deadline to enroll in Obamacare, administration officials extended the open enrollment period until April 15 to accommodate the people who may have struggled to complete their applications due to technological issues.

Just over two weeks ago, the administration announced that Obamacare enrollment had reached 7.1 million — surpassing expectations after HealthCare.gov’s rocky rollout in October. The nonpartisan Congressional Budget Office (CBO) originally projected seven million enrollments, and revised that figure down to six million after persistent website glitches plagued the exchange websites in the fall. But sign-ups picked up steam as the deadline neared. The 8 million figure includes 3.7 million sign-ups between March 1 and April 15.

“This thing is working,” Obama said.

The administration has not yet released more detailed data about the people who have signed up for new plans, so it’s unclear how many were previously uninsured and how many have paid their first premium. Even without further numbers from the White House, however, several recent outside reports suggest that the health reform law is on solid footing.

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And despite concerns that Obamacare wouldn’t be able to recover from HealthCare.gov’s disastrous rollout, several major insurers say they’re optimistic about the law, and eager to continue offering plans on the new marketplaces during the next open enrollment period. Insurance companies like UnitedHealth Group, Kaiser Permanente, Molina Healthcare, and Wellmark are interested in maintaining their presences on the state-level exchanges, and some are considering expanding, according to Politico.

Although there have been some ominous predictions that Obamacare will cause health insurance premiums to skyrocket, the statisticians working with insurers to project next year’s insurance premium rates report that there won’t be double digit hikes. While there will likely be variation in individual costs, officials from the Society of Actuaries expect mostly modest premium increases, saying “the double-rate increases we’ve been hearing are probably exaggerated.”

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Some of the concerns over rising premiums stemmed from the assumption that there won’t be enough young and healthy people in the exchanges to balance out the older and sicker enrollees. But those fears may be unfounded. Obama announced on Thursday that 35 percent of enrollees are under the age of 35, and 28 percent are between the ages of 18 and 34. Since previous estimates had skewed older, that indicates a rush of younger people signed up at the last minute. Those numbers fall in line with the experience that Massachusetts has when it enacted similar health care reforms in 2006. Young people gradually signed up over time, and by the end of the enrollment period, about 28 percent of Massachusetts enrollees were between the ages of 19 and 34.

As President Obama noted today, thanks to Republican governors and legislature’s continued resistance to Medicaid expansion, an estimated 5.7 million low-income people will remain uninsured, i.e., the Red State “coverage gap.”

GOP opposition to health care reform is unsustainable. Voters in Red States are going to rise up and throw their sorry asses out of office for being intellectually bankrupt and morally depraved in providing for health care.

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